High Intensity Focused Ultrasound (HIFU) as a Treatment for Fibroadenoma: a Prospective Study

Abstract

Aim: Fibroadenoma is a common benign breast neoplasm, treatment include regular surveillance or surgical excision. High‐intensity focused ultrasound (HIFU) is a new ablative technique. During the procedure, the index lesion is localized with a diagnostic USG. The probe is integrated concentrically and confocally with the HIFU transducer so as to monitor the target by real‐time sonography, to guide HIFU energy deposition, and to assess the extent and progress of coagulative necrosis during the ablation. Methods: This is a prospective study on HIFU in treating fibroadenoma. Institutional Board Review approval was sought. All patients with biopsy‐proven fibroadenoma were given the management option of HIFU, excision or close surveillance. Patients who consented for HIFU were screened for eligibility. Radiologically suspicious lesion or lesion being less than 6 mm beneath the skin were excluded. All procedures were performed and followed‐up by single specialists to minimize the inter‐observer error. Results: 50 patients consented for HIFU; 2 patients were excluded. 48 patients were treated from February 2016 to June 2019. Mean age was 37.7 years old (Range 20‐60). 30 (62.5%) patients have completed 12‐month follow‐up while 40 (83.3%) patients have completed 6‐month follow‐up. 17 (56.7%) patients achieved >50% volume reduction at 12‐month, while 8 (26.7%) patients achieved 25‐50% volume reduction at 12 months. Mean volume change at 12‐month was ‐57% (Range ‐12 to ‐100%). There were no reported complication including skin burn. Conclusion: This study represents one of the largest series on HIFU for fibroadenoma. HIFU is a safe and effective alternative for treatment of fibroadenoma.